Customer Information

The electricity bill must be referenced to complete this section. Enter the requested information exactly as it appears on the bill. Inaccurate submission may result in the inability to process this application.

Contact Information

Charging Station Information

Calculating Average Capacity: If the capacity of chargers differs (e.g., 5 chargers at 50 kW and 5 chargers at 100kW), provide the average capacity (e.g. 75 kW in this example).

Customer Certification

• On behalf of the account holder, I request enrollment of this account in the EVC Rate.

• I confirm that the EV charging station associated with the account meets each of the following eligibility criteria:

• Required Charger Type: The charging station contains at least one DCFC stall (also referred to as a Level 3 charger)
• Load Use: At least 90% of the account’s total monthly peak demand relates to EV charging (i.e., the DCFC and any lower level, non-DCFC chargers); auxiliary loads (e.g. for vending machines, tire inflation or restrooms) do not exceed 10% of the total monthly peak demand
• Peak Demand Range: The account has a monthly peak demand that is equal to or greater than 50 kW but less than 5,000 kW
• Load Factor: The account has or is expected to have a 12-month average load factor equal to or less than 20% (or 0.20) calculated according to the following formula
• Load Factor month = Electricity Consumed (kWh) month / Maximum Demand(kW) month x Number of Hours month
• Fleet Exemption: The charging station does not primarily serve commercial and/or public sector fleets
• Distributed Energy Resource (DER) Capacity Limit: The total DER nameplate capacity of any DER connected behind the account’s meter does not exceed the total annual peak demand of the charging station.

• I certify that the information provided on this form is true and accurate, and that in the event Bluewater Power Distribution Corporation has any questions about it, I will provide true and accurate responses.

• I acknowledge that I am required to notify Bluewater Power Distribution Corporation within 30 days of ceasing to meet the eligibility requirements, resulting in the account’s removal of the EVC Rate.

• I acknowledge that if Bluewater Power Distribution Corporation determines that I deliberately or recklessly provided false information on this form or in response to any of its questions about it, or that I deliberately or recklessly failed to notify Bluewater Power Distribution Corporation within 30 days of ceasing to meet the eligibility requirements, Bluewater Power Distribution Corporation will rebill the account for the difference between the EVC Rate and the higher RTSR that should have been charged, plus interest.

• I have authority to submit this form on behalf of the account holder.

All information submitted in this process will be used by Bluewater Power Distribution Corporation in support of its obligations under the Electricity Act, 1998 and the Ontario Energy Board Act, 1998, applicable Ontario Energy Board Codes and Rules, associated policies, standards and procedures and its license.

This information is being collected and used for billing purposes, and is subject to field investigation by Bluewater Power and disclosure to other authorities such as your municipality’s building and fire departments, and the province of Ontario to ensure the accuracy of the information provided. By signing this form, you consent to our collection, use and disclosure of the information provided for above information. Any information provided will be retained by Bluewater Power and treated in accordance with our Privacy Policy, and may be subject to review by the Province of Ontario or its agents.